Evidence map›Paper›PMID 30635226›Full record

SynthesisThe lancet. Diabetes & endocrinology2019

Change in albuminuria as a surrogate endpoint for progression of kidney disease: a meta-analysis of treatment effects in randomised clinical trials.

Hiddo J L Heerspink, Tom Greene, Hocine Tighiouart, Ron T Gansevoort, Josef Coresh, Andrew L Simon, Tak Mao Chan, Fan Fan Hou, Julia B Lewis, Francesco Locatelli and 5 more

2 registry-linked trialsOpen access · bronzeAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The lancet. Diabetes & endocrinology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 223 papers, 18 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
223citing papers in PubMed, 18 pooled it
26.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07667517 phase4not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Efficacy and Safety of Finerenone for the Early Regression of Albuminuria in Patients With Type 2 Diabetes Mellitus and Chronic Kidney Disease: A Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

TypeinterventionalSponsorFirst Affiliated Hospital of Zhejiang UniversityRan2026 to 2027Enrolled148ConditionsAlbuminuria, Type 2 Diabetes Mellitus (T2DM), Chronic Kidney DiseasesArmsFinerenone (BAY 94-8862), Placebo
NCT07719621 not yet recruitingnot on this mapstarted 2026, after this paper: background citation

Implication of Albuminuria Reduction and Other Cardiorenal Effects on The Risk of Heart Failure in Patients With CKD and T2D

TypeobservationalSponsorAeterna Medical Solutions SLRan2026 to 2026Enrolled50,000ConditionsCKD - Chronic Kidney Disease, Diabetes Mellitus Type 2
3 · Its place in the literature

Who cites it

223 citing papers in PubMed, 18 syntheses or guidelines pooled it, 357 citations in OpenAlex.

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163 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 13 institutions in 6 countries.

Hiddo J L HeerspinkDepartment of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Tom GreeneDivision of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
Hocine TighiouartInstitute for Clinical Research and Health Policy Studies, Boston, MA, USA; Tufts Medical Center, Boston, MA, USA; Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
Ron T GansevoortDepartment of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
Josef CoreshDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Andrew L SimonDivision of Nephrology, Boston, MA, USA.
Tak Mao ChanDepartment of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
Fan Fan HouDivision of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Julia B LewisDivision of Nephrology, Vanderbilt University, Nashville, TN, USA.
Francesco LocatelliDepartment of Nephrology and Dialysis, Hospital Alessandro Manzoni, Lecco, Italy.
Manuel PragaNephrology Department, Hospital Universitario 12 de Octubre, Madrid, Spain.
Francesco Paolo SchenaRenal, Dialysis and Transplant Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Andrew S LeveyDivision of Nephrology, Boston, MA, USA.
Lesley A InkerDivision of Nephrology, Boston, MA, USA. Electronic address: linker@tuftsmedicalcenter.org.
Chronic Kidney Disease Epidemiology Collaboration
Alessandro Manzoni Hospital · ITHarvard University · USVanderbilt University · USHospital Universitario 12 De Octubre · ESJohns Hopkins University · USSouthern Medical University · CNUniversity Medical Center Groningen · NLUniversity of Bari Aldo Moro · ITUniversity of Hong Kong · HKUniversity of Utah · USQueen Mary Hospital · CNTufts Medical Center · USUniversity of Groningen · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChange in albuminuria has strong biological plausibility as a surrogate endpoint for progression of chronic kidney disease, but empirical evidence to support its validity is lacking. We aimed to determine the association between treatment effects on early changes in albuminuria and treatment effects on clinical endpoints and surrograte endpoints, to inform the use of albuminuria as a surrogate endpoint in future randomised controlled trials.

methodsIn this meta-analysis, we searched PubMed for publications in English from Jan 1, 1946, to Dec 15, 2016, using search terms including "chronic kidney disease", "chronic renal insufficiency", "albuminuria", "proteinuria", and "randomized controlled trial"; key inclusion criteria were quantifiable measurements of albuminuria or proteinuria at baseline and within 12 months of follow-up and information on the incidence of end-stage kidney disease. We requested use of individual patient data from the authors of eligible studies. For all studies that the authors agreed to participate and that had sufficient data, we estimated treatment effects on 6-month change in albuminuria and the composite clinical endpoint of treated end-stage kidney disease, estimated glomerular filtration rate of less than 15 mL/min per 1·73 m

findingsWe identified 41 eligible treatment comparisons from randomised trials (referred to as studies) that provided sufficient patient-level data on 29 979 participants (21 206 [71%] with diabetes). Over a median follow-up of 3·4 years (IQR 2·3-4·2), 3935 (13%) participants reached the composite clinical endpoint. Across all studies, with a meta-regression slope of 0·89 (95% Bayesian credible interval [BCI] 0·13-1·70), each 30% decrease in geometric mean albuminuria by the treatment relative to the control was associated with an average 27% lower hazard for the clinical endpoint (95% BCI 5-45%; median R

interpretationOur results support a role for change in albuminuria as a surrogate endpoint for the progression of chronic kidney disease, particularly in patients with high baseline albuminuria; for patients with low baseline levels of albuminuria this association is less certain.

fundingUS National Kidney Foundation.

Indexed as

AlbuminuriaDisease ProgressionHumansKidney DiseasesPrognosisRandomized Controlled Trials as TopicRenal Insufficiency, ChronicRisk Factors

Identifiers

PMID30635226
OpenAlexW2908535040

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.